Which pupil finding is a sign of head trauma?

Which pupil finding is a sign of head trauma?

• A. Unequal pupils
• B. Normal pupil reaction
• C. Equal reactive pupils
• D. Dilated with reactive

Answer: (A)

Pupil size and light reaction are quick clues to brain function after head trauma. When pupils are unequal, this anisocoria can indicate injury to the brain or to the nerves that control eye movement. One pupil may be larger and/or less responsive to light, suggesting possible cranial nerve III damage or rising intracranial pressure with risk of brain herniation. That combination—new or pronounced unequal pupils with abnormal reaction—is a serious red flag and warrants immediate assessment and rapid transport. Normal pupil reaction isn’t a sign of head injury, and equal reactive pupils are generally reassuring but do not point to a trauma-related problem. A pupil that is dilated but still reactive can occur for various reasons and is less specific; it may be concerning, but the clear, distinct sign of head trauma here is the unequal pupil size.

Pupil size and light reaction are quick clues to brain function after head trauma. When pupils are unequal, this anisocoria can indicate injury to the brain or to the nerves that control eye movement. One pupil may be larger and/or less responsive to light, suggesting possible cranial nerve III damage or rising intracranial pressure with risk of brain herniation. That combination—new or pronounced unequal pupils with abnormal reaction—is a serious red flag and warrants immediate assessment and rapid transport.

Normal pupil reaction isn’t a sign of head injury, and equal reactive pupils are generally reassuring but do not point to a trauma-related problem. A pupil that is dilated but still reactive can occur for various reasons and is less specific; it may be concerning, but the clear, distinct sign of head trauma here is the unequal pupil size.